Saquinavir/Ritonavir Monotherapy as a New Nucleoside-Sparing Maintenance Strategy in Long-Term Virologically Suppressed HIVInfected Patients

Title: Saquinavir/Ritonavir Monotherapy as a New Nucleoside-Sparing Maintenance Strategy in Long-Term Virologically Suppressed HIVInfected Patients

Volume: 8 Issue: 6

Author(s): Patricia Echeverria, Pere Domingo, Mar Gutierrez, Mateo Gracia, Monse Fuster, Jose Molto, Jordi Puig, Nuria Perez-Alvarez, Bonaventura Clotet and Eugenia Negredo

Affiliation:

Keywords: Saquinavir/ritonavir, monotherapy, simplification strategy, chronic virologically suppressed HIV-infected patients

Abstract: Background: The high antiviral potency and low toxicity of saquinavir/ritonavir (SQV/r) prompted us to assess a viable strategy in chronic virologically suppressed HIV-infected patients. Methods: A randomized, multicenter pilot trial. Patients taking triple HAART with (VL < 50 copies/mL) and no history of virological failure with a protease inhibitor (PI) or PI-related resistance were assigned in a 2:1 ratio to receive SQV 1000 mg/ritonavir 100 mg BID (SQV/r group) or to continue with their habitual treatment (control group). Comparisons were performed using the Mann-Whitney test for medians, the t test or ANOVA for means, and the χ2 or Fishers exact test for proportions. Results: 28 patients were randomized: 17 to the SQV/r group and 11 to the control group. Only 1 patient from the SQV/r group experienced virological failure at week 48. A similar mean increase was observed in CD4+ T-cell counts in both groups at week 48. Three patients (17.6%) from the SQV/r group prematurely interrupted the study for reasons other than virological failure. HDL cholesterol increased significantly at week 48 in the SQV/r group (from 41±11 mg/dL to 56±35, P=.026); patients in the control group showed a decrease in LDL cholesterol (from 129±37 mg/dL to 107±17, P=.028). The median (IQR) trough plasma concentrations of SQV were 760 ng/mL (379.5-1332.25 ng/mL). Three patients had saquinavir concentrations lower than 100 ng/mL. Conclusion: SQV/r as monotherapy has proven to be a valid, safe, and economical option for virologically suppressed HIV-infected patients, especially in those who experience intolerance or toxicity with nucleoside analogs.

Cite this article as:

Echeverria Patricia, Domingo Pere, Gutierrez Mar, Gracia Mateo, Fuster Monse, Molto Jose, Puig Jordi, Perez-Alvarez Nuria, Clotet Bonaventura and Negredo Eugenia, Saquinavir/Ritonavir Monotherapy as a New Nucleoside-Sparing Maintenance Strategy in Long-Term Virologically Suppressed HIVInfected Patients, Current HIV Research 2010; 8 (6) . https://dx.doi.org/10.2174/157016210793499358